The Call-On-Doc Guide to Rosacea

Published on Apr 11, 2024 | 1:00 PM

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Affecting millions of Americans, rosacea is a common skin disease that primarily affects the faces of both men and women. Categorized into different types, the condition is generally identified by chronic flushing, irritation, and acne formation on the affected skin. When left untreated, rosacea can thicken skin and form red bumps that become difficult to treat. While rosacea cannot be cured, treatment can be effective for reducing and minimizing symptoms.

What are rosacea symptoms

Facial Redness: This is one of the most common and noticeable symptoms of rosacea. It typically appears as a persistent redness on the central part of the face, including the cheeks, nose, forehead, and chin. The redness can vary in intensity and may come and go in flare-ups.

Visible Blood Vessels: Small blood vessels, called telangiectasia, can become visible on the skin's surface, especially in areas of persistent redness. These blood vessels may appear as fine red lines or spider veins and are a result of inflammation and dilation of blood vessels in the skin.

Pimple-like Bumps: Rosacea can cause small, red or pus-filled bumps (pustules) to develop on the face. These bumps are not acne but can be similar in appearance. They are often tender or painful and may occur alongside other symptoms like redness and visible blood vessels.

Eye Irritation: Ocular rosacea refers to symptoms affecting the eyes. These can include dryness, itching, burning, redness, sensitivity to light (photophobia), blurred vision, or a feeling as if a foreign object or something is in the eye. Ocular symptoms can occur independently or alongside skin symptoms.

Thickened Skin (Rhinophyma): Rhinophyma is a less common but more severe symptom of rosacea, primarily affecting men. It involves thickening of the skin on the nose, leading to a bulbous and bumpy appearance. Rhinophyma is thought to result from long-term inflammation and enlargement of oil glands in the nose.

Sensitive Skin: People with rosacea often have sensitive skin that can react strongly to various triggers, such as harsh skincare products, extreme temperatures, sunlight, wind, spicy foods, alcohol, and stress. This sensitivity can manifest as burning, stinging, itching, or tightness in the skin.

Flushing and Blushing: Flushing and blushing episodes are common in rosacea and can be triggered by various factors, including emotional stress, hot beverages, spicy foods, alcohol consumption, temperature changes, and certain medications. These episodes involve sudden and temporary reddening of the face, often accompanied by a warm sensation.

Are there different types of rosacea?

Rosacea has four types: vascular, inflammatory, phymatous, and ocular. These types have subtle differences but generally share many of the same symptoms. 


  • Also known as erythematotelangiectatic rosacea.
  • It primarily involves visible blood vessels (telangiectasia) and facial redness.
  • The skin appears persistently red, especially on the central part of the face (cheeks, nose, forehead, chin).
  • The redness can range from mild to severe.
  • It is often accompanied by flushing and blushing episodes triggered by factors like heat, spicy foods, alcohol, emotional stress, and sunlight.
  • Over time, the small blood vessels on the skin's surface become more prominent, contributing to the characteristic appearance of vascular rosacea.
  • Individuals with this type of rosacea may also experience skin sensitivity, burning sensations, and a tendency for the redness to worsen with certain triggers.


  • Also known as papulopustular rosacea, features acne-like bumps (papules and pustules), redness, and swelling on the face.
  • These bumps are caused by inflammation of the hair follicles and oil glands, not typical acne bacteria.
  • The skin may appear rough, bumpy, and sensitive to touch.
  • Inflammatory rosacea often coexists with vascular rosacea, resulting in a combination of symptoms like facial redness, visible blood vessels, and inflammatory bumps.
  • Flare-ups can occur periodically, worsening the acne-like lesions and redness.
  • Triggers for inflammatory rosacea include hot beverages, spicy foods, alcohol, stress, and certain medications.


  • A less common subtype characterized by thickening of the skin, most commonly on the nose (rhinophyma), but it can also affect other facial areas like the chin, forehead, and cheeks.
  • The skin becomes bumpy, enlarged, and may develop a bulbous or irregular appearance.
  • It is more prevalent in men and is thought to result from long-term inflammation, enlargement of oil glands (sebaceous hyperplasia), and buildup of connective tissue in the affected areas.
  • Individuals with phymatous rosacea may also experience other rosacea symptoms such as redness, flushing, and visible blood vessels.
  • Treatment may involve surgical procedures like laser therapy or dermabrasion to reduce thickened skin and improve cosmetic appearance.


  • Ocular rosacea is a common manifestation of rosacea that affects the eyes.
  • Symptoms can include dryness, redness, irritation, sensitivity to light (photophobia), blurred vision, and a feeling of grittiness or foreign body sensation in the eyes.
  • It may occur independently of skin symptoms or alongside facial redness and inflammation.
  • The condition can lead to eye discomfort, redness of the eyelids (blepharitis), conjunctivitis, and in severe cases, corneal damage.
  • Managing ocular rosacea requires specific interventions such as eyelid hygiene, lubricating eye drops, topical or oral antibiotics to reduce inflammation, and avoiding triggers that worsen eye symptoms.
  • Regular eye exams by an ophthalmologist are recommended for individuals with ocular rosacea to monitor eye health and prevent complications.

What causes rosacea flare ups?

Rosacea flare-ups can be triggered by various factors, and the specific triggers can vary from person to person. Some common triggers that can cause rosacea flare-ups include:

Sunlight: Exposure to sunlight, particularly ultraviolet (UV) radiation, is a common trigger for rosacea flare-ups. Protecting the skin from sun exposure with sunscreen and wearing hats or protective clothing can help reduce flare-ups.

Temperature Extremes: Extreme temperatures, such as hot weather, cold weather, saunas, hot baths, and steam rooms, can trigger rosacea flare-ups. Rapid temperature changes can also exacerbate symptoms.

Spicy Foods and Hot Beverages: Consuming spicy foods, hot beverages (such as coffee or tea), and alcoholic beverages can lead to flushing and increased redness in people with rosacea.

Emotional Stress: Stress and strong emotions, such as anxiety, anger, embarrassment, or excitement, can trigger rosacea flare-ups. Stress management techniques like meditation, deep breathing, and relaxation exercises may help reduce flare-ups.

Physical Exertion: Strenuous exercise, heavy lifting, and intense physical activity can cause flushing and increased blood flow to the face, leading to rosacea flare-ups in some individuals.

Certain Foods and Beverages: Besides spicy foods and hot beverages, other dietary triggers for rosacea include dairy products, chocolate, citrus fruits, tomatoes, soy sauce, vinegar, and aged cheeses. Keeping a food diary can help identify specific triggers for individual cases.

Alcohol Consumption: Alcohol, especially red wine, beer, and spirits, is a common trigger for rosacea flare-ups. Limiting alcohol consumption or avoiding certain types of alcoholic beverages may help manage symptoms.

Harsh Skincare Products: Using harsh skincare products, such as exfoliants, astringents, and abrasive cleansers, can irritate the skin and worsen rosacea symptoms. Gentle, non-comedogenic skincare products are recommended for people with rosacea.

Certain Medications: Some medications, including topical steroids, vasodilators, blood pressure medications, and certain acne treatments, can trigger or exacerbate rosacea symptoms. Consulting a healthcare professional before starting or changing medications is important for individuals with rosacea.

Environmental Factors: Environmental factors like pollution, wind, humidity, and indoor heating or air conditioning can also contribute to rosacea flare-ups by irritating the skin and causing inflammation.

What causes rosacea?

Rosacea can be caused by a number of different reasons, with some patients only having one cause and others having a combination of multiple. The most common rosacea causes include: 

Genetics: There is evidence to suggest that genetics plays a role in rosacea. People with a family history of rosacea are more likely to develop the condition themselves, indicating a genetic predisposition.

Abnormal Immune Response: It is thought that an abnormal immune response may contribute to the inflammation and redness seen in rosacea. The immune system's reaction to certain triggers may lead to the dilation of blood vessels and the release of inflammatory substances in the skin.

Blood Vessel Abnormalities: Abnormalities in blood vessels, such as increased vasodilation (widening of blood vessels) and vascular hyperreactivity, are associated with rosacea. These vascular changes can contribute to the characteristic redness and flushing seen in the condition.

Environmental Triggers: Various environmental factors can trigger or exacerbate rosacea symptoms. These triggers include exposure to sunlight (UV radiation), extreme temperatures (hot or cold), wind, humidity, spicy foods, alcohol, hot beverages, emotional stress, and certain skincare products or cosmetics.

Microbial Factors: Although not fully established, microbial factors, such as the presence of certain bacteria (e.g., Helicobacter pylori) or mites (e.g., Demodex folliculorum and Demodex brevis), have been implicated in the development of rosacea. These microorganisms may interact with the skin and immune system, contributing to inflammation and symptom onset.

Who is more likely to get rosacea?

Rosacea can affect people of any age, gender, or ethnic background, but certain factors may increase the likelihood of developing the condition. Individuals with fair skin, particularly those of Northern European descent, are more susceptible to rosacea. Additionally, women are more commonly affected than men, although men may experience more severe symptoms, especially in the form of rhinophyma. 

Genetics also play a role, as a family history of rosacea increases the risk of developing the condition. Other risk factors include being between the ages of 30 and 60, having a history of acne or a tendency to flush easily, and experiencing hormonal fluctuations.

How is rosacea diagnosed?

While there are no specific tests concerning rosacea, doctors identify rosacea visually. Alongside a discussion about symptoms, reactions to certain stimuli, and whether you have a family history, dermatologists typically don’t need much information beyond that to provide rosacea treatment. 

How is rosacea treated?

Rosacea treatment typically involves topical medications, like Metrogel, alongside lifestyle changes to manage the symptoms to a point where a person can find long-lasting relief. While there is no cure, current options have been known to be effective, especially when used regularly and in conjunction with home remedies. 

Can rosacea go away?

Rosacea is a chronic condition that typically doesn't go away on its own. However, with proper management and treatment, it is possible to control and minimize its symptoms. 

What ways can you manage your rosacea?

Rosacea is linked to multiple factors in everyday life, from what’s eaten, to stress levels, the environment, and more. Most often, the following tips have helped most people reduce their rosacea symptoms along with treatment: 

Protect Your Skin from Sun Exposure: Wear sunscreen daily with an SPF of at least 30, and use protective clothing, hats, and sunglasses when outdoors to shield your skin from UV radiation, a common rosacea trigger.

Practice Gentle Skincare: Use mild, non-irritating skincare products suitable for sensitive skin. Avoid harsh cleansers, scrubs, and abrasive products that can aggravate rosacea.

Moisturize Regularly: Keep your skin well-hydrated with a gentle, non-comedogenic moisturizer to help maintain its barrier function and reduce dryness and irritation.

Identify and Avoid Triggers: Keep a diary to track potential triggers for your rosacea flare-ups, such as spicy foods, hot beverages, alcohol, extreme temperatures, stress, and certain medications. Try to minimize exposure to these triggers.

Manage Stress: Practice stress-reducing techniques such as meditation, deep breathing exercises, yoga, or mindfulness to help lower stress levels, which can contribute to rosacea flare-ups.

Maintain a Healthy Lifestyle: Eat a balanced diet rich in fruits, vegetables, lean proteins, and whole grains. Limit your intake of spicy foods, hot beverages, and alcohol, which can exacerbate rosacea symptoms.

Avoid Smoking: Smoking can worsen rosacea symptoms and negatively impact skin health. Quitting smoking or avoiding exposure to smoke can be beneficial.

Stay Cool: Keep cool by staying in air-conditioned environments during hot weather, using fans, and avoiding overheating, as heat and humidity can trigger rosacea flare-ups.

Regular Exercise: Engage in regular, moderate exercise, such as walking, swimming, or yoga, which can help reduce stress and promote overall well-being.

Best foods to eat and avoid for rosacea

Anti-inflammatory Foods: Include plenty of anti-inflammatory foods in your diet, such as fruits (especially berries), vegetables (particularly leafy greens), whole grains, nuts, seeds, and fatty fish rich in omega-3 fatty acids (e.g., salmon, mackerel, sardines). These foods may help reduce inflammation in the body, including inflammation associated with rosacea.

Hydration: Drink an adequate amount of water throughout the day to stay hydrated and support overall skin health. Avoid excessive consumption of dehydrating beverages like alcohol and caffeinated beverages, which can exacerbate rosacea symptoms.

Avoid Triggers: Identify and avoid dietary triggers that may worsen your rosacea symptoms. Common triggers include spicy foods, hot beverages, alcohol (especially red wine), caffeine, dairy products, chocolate, citrus fruits, tomatoes, and vinegar. Keep a food diary to track how different foods affect your skin.

Limit Sugar and Processed Foods: Minimize your intake of sugary foods, refined carbohydrates, and processed foods, as these can contribute to inflammation and may exacerbate rosacea symptoms in some individuals.

Probiotics: Consider incorporating probiotic-rich foods into your diet, such as yogurt, kefir, sauerkraut, kimchi, and other fermented foods. Probiotics may help support gut health and immune function, potentially benefiting skin conditions like rosacea.

Healthy Fats: Include healthy fats in your diet from sources like avocados, olive oil, nuts, and seeds. These fats contain antioxidants and essential fatty acids that can support skin health and reduce inflammation.

Moderate Spices: While spicy foods can be triggers for some people with rosacea, others may tolerate mild spices like turmeric, ginger, and cinnamon well. Experiment with spices cautiously and monitor how they affect your skin.

Get rosacea relief through Call-On-Doc Today

Getting rosacea treatment has never been easier when you choose Call-On-Doc. Not just thanks to our prescription refill option, but also through the products we offer specifically for rosacea management, with the best options including: 

Skin Balancing Moisturizer: The combination of Aloe Vera, Squalane, and Glycerin in the skin balancing moisturizer can be beneficial for rosacea-prone skin. Aloe Vera has soothing and anti-inflammatory properties that can help calm redness and irritation associated with rosacea. Squalane is a lightweight moisturizer that helps hydrate the skin without clogging pores, providing essential moisture to dry and sensitive skin often seen in rosacea. Glycerin is a humectant that attracts and retains moisture, helping to maintain the skin's hydration levels and improve overall skin barrier function, which is important for managing rosacea symptoms. Together, these ingredients can help soothe, hydrate, and protect rosacea-affected skin.

Hydrating Serum: The combination of Sodium Hyaluronate, Glycerin, and Sodium PCA deeply hydrates and maintains moisture in rosacea-prone skin. Camellia Sinensis (White Tea) Extract provides anti-inflammatory and antioxidant benefits, soothing redness and protecting against UV damage. Zinc PCA and Copper PCA help condition the skin and regulate oil production, promoting a balanced complexion for individuals with rosacea.

Green Tea Facial Mist: Our green tea facial mist contains Ascorbic Acid, which brightens and evens out skin tone, along with Panthenol (Pro Vitamin B) to nourish and strengthen the skin barrier. Witch Hazel provides astringent properties, tightening and toning the skin, while Chamomile Extract and Lavender Extract soothe inflammation and reduce redness, particularly beneficial for sensitive skin conditions like rosacea. Green & White Tea Extracts offer antioxidant protection, neutralizing free radicals and reducing UV damage, complemented by Sea Salt's exfoliating benefits for improved skin texture and renewal.

Our products are specifically designed to help you manage your condition, pairing well with treatment and a lifestyle that targets rosacea symptoms. Order yours today!

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Wayne Hahne,

English graduate and Call-On-Doc’s medical resource guide, Wayne C. Hahne is an experienced and passionate medical education content expert. Through diligent research, provider interviews and utilizing the industry's leading resources for wellness information, it is Mr. Hahne’s personal mission to educate the general public on medical conditions with in-depth and easy-to-understand written guides.

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